Fastenau, Philip Stephen

Fastenau, Philip Stephen is an individual health care provider with primary practice located at 11100 Euclid Ave , Cleveland OH 44106-1716. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Fastenau, Philip Stephen can be contacted via phone (216) 844-2400.

Contact Information

Primary practice address
11100 Euclid Ave Cleveland OH 44106-1716
Phone: (216) 844-2400
Fax: (216) 844-1703
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 6463 Ohio

Profile Details

NPI number 1407012883
LBN Legal business name Fastenau, Philip Stephen
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2008
Last updated Dec 8th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407012883 NPPES
Ohio Other P00690297 MEDICARE RAILROAD
Ohio MEDICAID 2842786 MEDICARE RAILROAD

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